How often does Surgery for Droopy Eyelids Lead to the inability to Close Eyelids?

Does having excess skin on the eyelid help when it comes to having a successful eyelid surgery? 

Doctor Answers 1

Appropriate but theoretical questions.

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How often does surgery for droopy eyelids lead to the inability to close the eyelids?  

There is actual eyelid ptosis where the eyelid itself is droopy and then there is a very common condition when the upper eyelid fold is excessive called dermatochalasis that is sometimes described as a droopy eye.  The two conditions are different, can exist separatedly or occur together.  Dermatochalasis is addressed with classic blepharoplasty.  Upper eyelid ptosis must be addressed with ptosis surgery.  There are three basic types of ptosis surgery.  The most common ptosis surgereries strengthen or reinforce the levator tendon that extends from a muscle that lifts the upper eyelid open called the levator palpebrae superioris muscle.  Most commonly the ptosis results when this tendon begins to slip from its attachments in the upper eyelid.  Less commonly, there can be a congential weakness of this muscle.  This is a more complex situation that is addressed with a class of surgeries called frontalis suspension procedures.

The inability to close the eyelids is called lagophthalmos.  It can occur after eyelid surgery.  It is unusual for ptosis surgery to cause lagophthalmos.  However lagophthalmos is much more common when too much skin is removed from the upper eyelid.

Does having excess skin on the eyelid help when it comes to having successful eyelid surgery? 

The here no it does not help.  It has to be addressed and it makes fixing the ptosis more complicated.

I would recommend that you see a fellowship trained oculoplastic surgoen who is also a board certified ophthalmologist.  The Amercian Soceity for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory that will help you find a well qualified surgeon in your area (  Many of these types of situations are consider medically necessary.  More mild cases are considered cosmetic in nature.


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